Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NP0017X | Pediatric Chiropractor | CHIR009629 | GA |
NPI | 1821454448 |
---|---|
Provider Name | Dr. Lotem Leah Lako |
First Address | Roswell, GA 30076-2165 |
Second Address | Roswell, GA 30076-2165 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 12/01/2016 |
Last Update Date | 16/04/2020 |